UPDATE Vol. 29 No. 2 ISSN June 2013

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1 UPDATE Vol. 29 No. 2 ISSN June 2013 THE COLLEGE OF VETERINARIANS OF ONTARIO Contents: President s Message 2-3 Public Member s term ends 4 Council Highlights 4 Meet & Greet at OVC 5 Proposed By-Law Changes 6 THE COLLEGE OF Members Forum & AGM 6 VETERINARIANS Council Election 7 By-Election OF ONTARIO 8 Registration 9 Quality Practice Member Wellness Accreditation 14 Complaints Case 15 Register Updates 16 In Memoriam 16 Strategic Planning College identifying areas of focus The College Council is well into the planning for setting its next strategic objectives to cover These next objectives are intended to advance self-regulation and veterinary medicine within the current context of public interest and public expectation. To assist with this, a forum was held on April 10th. Its title, Visualizing the Future of Regulation and Veterinary Medicine in Ontario, describes its focus. There were over 40 individuals in attendance including Council, staff, speakers, invited guests, and eight veterinarians invited from the College s veterinary network, VetNet. The perspectives shared were far-ranging, provocative and engaging. Discussions led to identified areas for focus that will contribute to Council s decision at its meeting in June. Your voice will also be important in the strategic planning. Once the top three or four objectives are determined, the College will then post them for feedback from licensed members. The structure for this will be an online community where comments can be posted and reviewed by all. Please watch for your invitation to join the dialogue. Jane Enright, of J. Enright Consulting and Associates, facilitated discussions among Council, staff and veterinarians during the strategic planning forum. College of Veterinarians of Ontario Phone: Website: Gordon Street Guelph, Ontario N1L 1G6 Fax: inquiries@cvo.org Strengthening the veterinary profession through quality practice and public accountability.

2 CVO News ~ President s Message WHY are you doing this to us? This is a question l received at our January Annual General Meeting and it is a recurrent theme that has emerged from the 1,100 respondents who recently completed our Reputation Survey. Perhaps it is not a surprising question when we realize that the Veterinarians Act has created constituencies for the purposes of electing Councillors, but that the CVO is not a parliamentary based organization. The CVO s regulatory licensure model elects Councillors to represent only the public s interest, not the interests of the veterinarians that elected them. In fact, the owner of the CVO is the public, not the veterinarian, yet it is the veterinarian s annual fees that are used to finance the College s operational expenses. In fact, the veterinarian is a client of the College, as are members of the public or governments. The people through the Government of Ontario gave us our Act. It tells us that the College s principle objective is to regulate the practise of veterinary medicine in Ontario and to govern its members in accordance with the Veterinarians Act, the regulations and the by-laws in order that the public interest may be served and protected. As such, Councillors have an obligation to do whatever they can, to the best of their ability, to direct the College in such a manner as to protect the CVO so that it can realize its mandate to serve and protect the public, not the profession. All professions in Ontario are regulated in the same manner. As The fact is, veterinarians have a stake in what the College does and the College cannot effectively deliver on its public interest mandate without the assistance of its licensed members. a result of its accountability to the public, the CVO publishes an Annual Report, publishes discipline findings, convenes open Council meetings, and undertakes projects to strengthen the profession through quality practice initiatives. Public interest is also why we have members of the public appointed to our Council, and why the CVO itself is monitored by other regulators, such as the Fairness Commissioner, to ensure we are delivering on those public expectations and being unbiased in our decision making. What is the public interest? Many public practise veterinarians work fulltime in the public s interest delivering on a broad range of activities including field extension, public health or facilitating the production of safe food. The CVO s public interest repertoire however is limited to determining who enters the profession, who stays in the profession and what standards the profession should maintain. Those standards then speak to CVO initiatives related to educating the profession and the public as to the competency of our veterinary practitioners. The CVO cannot simply leave you alone. It needs to protect the public and their animal patients from dangerous circumstances, Dr. Nina Szpakowski CVO President president@cvo.org provide the profession and the public with information so they can make informed decisions, regulate standards of knowledge, skill, ethics and qualifications, and when needed, exercise its powers to encourage compliance. This is why other topics, not directly related to our mandate but more related to veterinary self-interest or advocacy should to be directed to your veterinary association and not to the CVO. The fact is, veterinarians have a stake in what the College does and the College cannot effectively deliver on its public interest mandate without the assistance of its licensed members. The CVO s challenge is to determine how we balance the competing factors embedded in the work we endeavour to do in the public interest, be fair and reasonable with our licensed members without being unduly influenced, yet mindful of the broadening public appetite for more accountability from all professions. continued on next page June CVO Update

3 Update is the official publication of the College of Veterinarians of Ontario, informing members on regulatory issues, with the expectation that members will govern themselves accordingly. Update is charged with the responsibility of providing comprehensive, accurate and defensible information. College of Veterinarians of Ontario 2106 Gordon Street Guelph, Ontario N1L 1G6 Phone: (519) Toll-free: Fax: (519) Toll-free fax: Editor: Jan Robinson Assistant to the Editor: Kim Huson Publication mail agreement number: CVO Staff Ms. Jan Robinson - Registrar & CEO Ms. Aneeta Bharij Principal, Accreditation Ms. Megan Callaway Associate, Quality Practice Ms. Ashley Coles Associate, Standards & Policy Mr. Martin Fischer Investigations & Inspections Specialist Ms. Kim Huson Communications Specialist Ms. Chris Lana-Sarrate Associate, Investigations & Resolutions Ms. Sarah Large Associate, Corporate Services Ms. Lindsay Mitchell Principal, Registration Dr. Glenn Pettifer Senior Partner, Quality Practice Ms. Beth Ready Executive Partner, Corporate Services Ms. Rose Robinson Principal, Investigations & Resolutions Ms. Karen Smythe Senior Partner, Standards & Policy Ms. D-J Vandongen Ambassador, Corporate Services Mr. Don Huston Mr. Brian Redpath Mr. Dick Stewart Accreditation Inspectors President s Message continued from page 2 A scan of our landscape finds us having to consider the written or unwritten rules of other regulators, the implications of litigation including the evolving public concerns and perceptions related to diversity, transparency, animal welfare, science and business. Even doing nothing, has its own risks. This is why Councillors are so important as they gift their time, skills and ideas to the College. They also must work particularly hard at listening to and engaging in informed debate to educate themselves on the matters for decision at Council. Further they must be aware of and keep in perspective their own biases so that CVO News Council as a whole can have frank and open dialogue, and explore perspectives, strategies and insights so that wise decisions can be taken. In this way, Council s decisions are the binding directions given to the College for implementation so that the public is served and protected. So, why are we doing this to you? The CVO does what it does because the public, including their elected public representatives, expects this from us, believing our profession can make the right choices in their best interest. Even if there are bumps along the way, we will find the best solution that will preserve the public s confidence in our wonderful and caring profession. Strategic Planning Forum Approximately 40 people attended the College s forum to help provide a focus for the next strategic plan. Top: A panel discussion focused on the Evolving Context of Veterinary Medicine included Dr. Joel Rumney, Dr. Mark Gemmill and Dr. Darryl Bonder. Other speakers included Chief Veterinarian for Ontario Dr. Greg Douglas, OVC Dean Dr. Elizabeth Stone, Dr. Warren Skippon of the CVMA and Mr. Irwin Fefergrad, Registrar at the Royal College of Dental Surgeons. Bottom: Council, staff and veterinarians participated in discussions surrounding future priorities. CVO Update 3 June 2013

4 CVO News ~ Council Highlights Council Meeting - April 11, 2013 Policy The following documents were considered by Council with decisions as noted: Practice Standard Medical Records Council discussed the draft Medical Records Professional Practice Standard, the draft Guide to the Professional Practice Standard: Companion Animal Practice and reviewed the different types of College policy publications. Council approved the revised Medical Records Professional Practice Standard and Guide with minor changes. Draft Position - Pain Management Council discussed a draft position on pain management which is based on the notion that the prevention and treatment of pain are pillars of veterinary medicine. The position supports the delivery of appropriate pain management, in keeping with current, speciesspecific standards of knowledge and care, as a requisite therapeutic component. On the basis of this opinion, Council asked staff to prepare a formal Position Statement on Pain Management. Minimum Standards for Zoo Veterinary Facilities Task Force Terms of Reference Council reviewed the draft terms of reference for the Minimum Standards for Zoo Veterinary Facilities Task Force. Dr. Marc Marin is chairing the task force which will include OVC faculty, licensees employed by a zoo, licensees providing services to a zoo and representatives of the Canadian Council on Animal Care and also the Canadian Association of Zoos and Aquariums. Over the next year, the task force will be drafting Minimum Standards for veterinary facilities in Ontario at zoos. Proposed By-Law Changes Schedule 2 (Fees) Council reviewed proposed changes to the Licence Fees section of the By-Laws to adjust fees to assure the College s future financial health. Council approved the proposed changes, in principle, for circulation and comment from licensees. Eligibility for Election Council reviewed proposed changes in the By-Laws which relate to eligibility for election. Council made suggestions that will be given further consideration. Annual General Meeting Council discussed the location options for the next Annual General Meeting. Last year, the meeting was held in Toronto in conjunction with the OVMA conference. Council decided to hold the AGM in Toronto again in Upcoming Council Meetings June 12, 2013 Special Council Meeting (teleconference) July 24, 2013 Council meetings begin at 9 a.m. and are open to the public. Council meetings are held at the College office at 2106 Gordon Street, Guelph. Please contact Beth Ready, bready@cvo.org, if you are planning to attend. Copies of Council Highlights and Minutes can be found on the College website at Public Member concludes term Councillor Lynn Patry completed her term on the College Council in May. The provincial government first appointed Ms. Patry to serve on the College Council in President Dr. Nina Szpakowski presented Ms. Patry with a certificate of recognition for her service to the Council. June CVO Update

5 CVO hosts Meet and Greet at OVC CVO News Graduating class gets acquainted with the College Top: CVO President Dr. Nina Szpakowski congratulates draw winners (l-r) Curtis Tubby, Laura Wozniak, Erin Bristow, Sarah Wells, and Stephanie Tait. Right: CVO Councillor Dr. Liz Saul chats with student veterinarian Anjelka Bosnjak. Bottom: The College s Senior Partner, Quality Practice, Dr. Glenn Pettifer speaks with students about services and programs available through the College of Veterinarians of Ontario. The Ontario Veterinary College s graduating class, the Golden Phoenixes, enjoyed a Meet and Greet reception with CVO Councillors and staff members in March. More than 60 students took the opportunity to attend the reception to get an idea of what s ahead after graduation. Students were provided with an information package detailing their roles and responsibilities as licensed members of the selfregulated veterinary profession in Ontario. Councillors and staff shared information with the students concerning licensing requirements, continuing professional development, quality practice and accreditation. The evening included welcoming remarks from CVO President Dr. Nina Szpakowski, Registrar Ms. Jan Robinson and Senior Partner for Quality Practice Dr. Glenn Pettifer. Students mingled with Councillors and staff to complete their passport questionnaires while getting to know the people and programs at the College. The College of Veterinarians of Ontario looks forward to welcoming the Golden Phoenixes as licensed members upon graduation. CVO Update 5 June 2013

6 CVO News - Consultation CVO extends consultation period to July 9th Licensed veterinarians have an opportunity to provide feedback to Council for its consideration prior to the final approval of any proposed By-Law changes. There is currently one proposed By-Law amendment for consideration which concerns changes to the College fees section of the By-Laws. Over the past several months Council has been studying in depth the long term financial health of the College. Council voted to increase the fees, in principle, earlier this year. These changes are reflected in the proposed By-Law amendments which have been circulated to licensed members by regular mail and and have been posted on the website since April. While meeting its legislated mandate on behalf of the public, the Council is aware of its opportunities to support Summary of Proposed Changes the introduction of one application fee for all classes of licensure, the introduction of an application fee for the reinstatement of a licence, including the payment of any outstanding fees, and a fee increase across all classes of licensure for the next four years, beginning January 1, 2014 (educational and short-term licenses are excluded). veterinarians in delivering safe, quality veterinary care. By increasing attention to customer service, improved resources, and a risk management approach to standard setting, the Council is aiming to highlight the value of veterinary regulation to all stakeholders. Further, the College is committed to annual long term financial forecasting to assure clearer planning and to assist in regular fiscal reporting to members. As per the Veterinarians Act, subsection 9.(3), members have 60 days to comment. Please provide your feedback to Beth Ready, Executive Partner, Corporate Services, on or before Tuesday, July 9, 2013, at 4 p.m. Further information, including full details of the proposed amendments and an online questionnaire can be found through the College s website at TAKE NOTE... Members Forum & Annual General Meeting January 29, 2014 Westin Harbour Castle, Toronto Held in conjuction with the OVMA Conference & Trade Show June CVO Update

7 E 13 LECTION Election Call On October 8, 2013 the College of Veterinarians of Ontario will hold elections in three constituencies, in accordance with the provisions of Regulation 1093 made under the Veterinarians Act. Until 4 p.m. on September 3rd, the College is receiving nominations for three Council positions. Members of Council are people like you - people who are dedicated to the profession and to providing high-quality veterinary medicine. As a member of Council, you may... Election Day - October 8th 55 Licensees receive nomination forms & election notice by July 16th 55 Nomination forms are submitted to the CVO by 4 p.m. on September 3rd 55 Election process is open ON-LINE from September 23rd to October 8th serve on the Accreditation Committee and help determine requirements for a professional environment. contribute to efforts to enhance veterinary medicine as a member of the Quality Assurance Committee. play an active role in reviewing position statements, guidelines and standards. analyze the College budget and determine financial priorities and licence fees to support the College s work. What is the Council? The CVO protects and serves the public interest through regulation of the practice of veterinary medicine. The CVO s governing Council comprises 13 veterinarians elected by veterinarians and five public members appointed by the provincial government. The President is elected from the Council. Supporting the work of the Council are five Statutory Committees, with public and veterinarian members on each. Are Councillors paid? Councillors are provided with a per diem, currently $400/day, and reimbursed for expenses for meeting days. How much time does it take? Councillors attend approximately five regular Council meetings per year. Members will also serve on at least one committee with varying time commitments. Constituency 1 - Essex, Kent, Lambton, Middlesex Constituency 4 - University of Guelph Constituency 6 - Wellington YOUR COLLEGE - YOUR COUNCIL - YOUR VOICE CVO Update 7 June 2013

8 CVO News By-Election called Constituency #2 to elect new Councillor A by-election will be held in Constituency #2 this summer. Due to the resignation of Dr. Scott Arnold, members of the constituency, which includes Brant, Elgin, Haldimand-Norfolk, Hamilton- Wentworth and Niagara, will be selecting a new Councillor on August 13th. The elected candidate will complete his/her term of office in Members who live or work in the area and specified Constituency #2 for their voting preference will be eligible to seek election and also to vote in the by-election on August 13th. Nomination forms have been circulated and can also be found on the College s website. To be a candidate, a licensed member must be nominated by two licensed members who are eligible to vote in the by-election. The nominee also signs the nomination form. Sarah Large All completed nomination forms must be received by the Registrar no later than 4 p.m. on July 9, Eligible voters will be sent an to enable them to access the online voting system and cast a vote online between July 30 and August 13, CVO By-Election Day August 13, 2013 Constituency #2 Brant, Elgin, Haldimand-Norfolk, Hamilton-Wentworth and Niagara If you have any questions about the by-election or its procedures, please contact Beth Ready at bready@cvo.org. CVO welcomes Associate, Corporate Services Sarah Large has joined the College as the Associate, Corporate Services. Sarah provides administrative support to the Registrar s Office and the Corporate Services team assisting with bookkeeping, coordinating the records management system, preparing packages for Council and Executive and also helping with reception. Sarah and her fiancé live in Guelph and share their home with their pets. Licence Renewal on the horizon Licensees can expect to receive their Online Annual Licence Renewal information early in October this year. Letters will be sent out providing login information at that time. Licensed members are reminded the deadline will be November 30, 2013, for submission of information and fees. In its first year, 96 percent of licensees took advantage of the online renewal process. Only 70 accounts were outstanding at the deadline which is an improvement over previous years. The College has hired a new online service provider and anticipates the renewal process will operate efficiently this year. Look for further information on renewals in e-update throughout the summer. Missed the Members Forum? Tune in to a recording of the College s Members Forum presentation by Richard Steinecke. A link to the recording is on the CVO website at June CVO Update

9 Registration Licence Types College offers seven different classes of licensure Did you know the College issues seven classes (or types) of licences? Here is what differentiates one licence class from another: General Licence Currently, the vast majority of members (4,253) hold a General licence. This means there is no restriction placed on their licences in terms of scope of practice, specific employers, species, or anything else. The Registrar issues General licences when all requirements are met. Restricted Licences Sixty-five veterinarians currently hold Restricted licences. Restricted licences are not a result of disciplinary action; rather, holders of Restricted licences are full members of the College, though their practice is limited to a specific species, or workplace, or scope. For example, applicants for Restricted licences might have become board certified without taking the NAVLE (which is a general requirement) or obtained additional academic credentials, such as a D.V.Sc., which qualifies them for practice in that specialty or practice area. Other applicants for Restricted licences have graduated from non-accredited veterinary programs and passed the NAVLE, but not all of the CPE components; they are eligible for Restricted licensure under supervision. The Registration Committee assesses all applications for Restricted licensure and determines whether or not the issuance of a licence with conditions and limitations is in the public interest. Other Licences with Restrictions The other five licence types are also restricted licences, in that they put conditions on the licence, but they are named specifically according to the place of employment of the veterinarian. Visit under Find a Veterinarian Look yourself up! Three of these licence types are specific to roles veterinarians have at the Ontario Veterinary College: Academic (professors) Educational (graduate students under supervision), and Post-Graduate/Resident (clinical appointments that do not require supervision) One is specific to federal government employees: Public Service Licence The last licence type is: Short-Term Licence, which requires supervision, is limited to 30 days, and issued to applicants who come to Ontario to perform specific duties (such as providing a specialized service) at specific locations LICENCE STATUS The current status of each licence is displayed on the public register. Here is what each status means: Active: The licensee has provided all required information and fees to the College. Expired: The term of the licence has ended. Revoked: After a hearing, a statutory committee of the College has decided that the former member is no longer eligible for licensure in Ontario. Suspended: After a hearing, a statutory committee of the College has decided that the member is temporarily required to stop practising in Ontario. Cancelled: The Registrar has cancelled the licence due to non-payment of fees or failure to file a return (completing the annual renewal form) as required by the by-laws. Licensees who have had their licences cancelled are also listed in Update. Resigned: The licensee has formally resigned from the College and is no longer authorized to practise. CVO Update 9 June 2013

10 Quality Practice Assisting the profession with continuous improvement in the delivery of veterinary care Since undertaking the role of Senior Partner, Quality Practice at the College in November of last year, it has been a pleasure for me to interact with so many veterinarians, individuals from other professional organizations and members of the public. You can well imagine the steepness of the learning curve associated with familiarizing myself with the regulatory framework, the work of Council, the issues at hand in the profession and the specific components of the Quality Practice programming. I certainly appreciate the support I have received from all of the CVO staff, Council and those members of the profession with whom I have had the opportunity to interact. Quality Practice In the context of self-regulated professions, Quality Practice programming is generally divided into Quality Improvement initiatives and Quality Assurance. Quality Improvement Most of you will be familiar with the College s Quality Improvement initiatives, those activities designed to assist the profession in continuous improvement in their delivery of veterinary care: Communication Workshops (Dealing with the Complex Client) Medical Records Workshops Medical Records Webinars Dr. Glenn Pettifer Senior Partner, Quality Practice gpettifer@cvo.org Online Medical Records Tutorials CPD portal: designed to assist veterinarians in engaging in reflective, self-directed continuing education. CPD Portal Peer Review of Medical Records: most of the records reviews take place in conjunction with accreditation inspections, but individual facilities can and do submit records for review, independent of any mandated process. The Quality Assurance Committee, myself and the Registrar are currently working on assisting the profession in answering three questions: 1. What does quality in the veterinary profession look like? 2. How can the profession assess this? 3. How can the profession communicate quality to the public? Quality Assurance At its most basic level, Quality Assurance involves an inspection by the intended consumer. As an example, when we shop for produce we engage in an inspection process (squeezing, smelling, visual examination) to get an idea of the quality of the product that is being offered for sale. This is a very simple system and places the risk associated with selecting poor quality produce on the consumer ( caveat emptor ). continued on next page June CVO Update

11 Quality CVO Practice News Continuous improvement in the delivery of veterinary care continued from previous page As the product becomes more complex in its design (for example, a car), the public looks to the manufacturers to engage in a Quality Assurance process that provides some oversight on the quality of the product. So too with the provision of professional services and care. In this context, it is a difficult, if not impossible, undertaking for the public to ascertain quality. In their search for some measure of quality, some individuals will use cost of service. Different individuals will have different orientations around cost. Some individuals will believe that the sole indicator of value and quality will be low cost, while others will adhere to the notion that you get what you pay for. While there are varied opinions on the intersection of cost, quality and value, I think that most would agree that there is not a simple, linear relationship between cost and quality of service. Since there is not a clear, single indicator in the determination of quality of veterinary care, the public looks to the profession to assist them in its search for safe, competent veterinary care. Rightfully so, as it makes sense that those most intimately knowledgeable of quality indicators in the profession are the professionals themselves. The Quality Assurance Committee, myself and the Registrar are currently working on assisting the profession in answering three questions: 1. What does quality in the veterinary profession look like? 2. How can the profession assess this? 3. How can the profession communicate quality to the public? The Registrar and/or I have been meeting with members of the profession across the diverse contexts in which veterinarians engage in professional activity to establish an alliance with veterinarians as we discuss these questions around quality assurance. This work is ongoing as we attempt to gather input from a broad sample of veterinarians. These meetings and conversations are just the beginning of our consultations with the entire profession. Rest assured that, as this process continues, you will have an opportunity to provide your own input and insight into these matters. The College looks forward to these interactions. Watch your inbox for -- Quality Matters For helpful information relating to the most common questions fielded by Dr. Pettifer, watch your in-box for Quality Matters. Through the monthly electronic newsletter, Dr. Pettifer shares answers to a wide range of questions that come from veterinarians and clinic staff. CVO Update 11 June 2013

12 Member Wellness Veterinarians and Wellness: Doctor, Heal Thyself! by Jerome B. Williams, DVM PREAMBLE: Veterinarians in Ontario have been accessing the services of the Professionals Health Program (PHP) since 2002, yet its existence is not widely known. The PHP (administered by the Ontario Medical Association) offers confidential assistance to veterinarians, physicians, and pharmacists facing mental health, substance use, and related difficulties--which threaten to stand in the way of their own well being, and which can also have an impact on their ability to provide safe care to their patients. Philosophically and financially, the College supports the PHP and its work as part of our mandate to serve the public interest. After reading a research article by Dr. Jerome Williams on the extremely high risk of suicide among veterinary students (Journal of Veterinary Medical Education), the College asked him if he would contribute a piece to Update. To our delight, he agreed. Here, Dr. Williams emphasizes the urgent need for veterinarians to acknowledge the unique challenges of the profession, to develop programs that will help themselves and their colleagues with these challenges, and to share information about the help that is already available. By including Dr. Williams s article in this issue of Update, the College hopes to do just that. Dr. Williams is the director of the Alabama Professionals Wellness Program. Physicians and veterinarians are often viewed as healers of the sick. While practitioners of various specialties focus on treating illnesses and modernizing the healing process for all walks of life, what happens to these health care providers when they become ill? To say the medical profession is extremely stressful for everyone is a serious understatement. The lives of all patients depend upon the practitioner s extensive skills to make the correct diagnosis and prescribe the proper treatment in a timely manner. When the practitioner is dealing with his/her own, underlying (and potentially undiagnosed) mental illnesses, care can become compromised sometimes, with disastrous results. Many forms of mental illness can emerge within early adulthood; veterinary students are no exception. According to suicide is the second leading cause of death for college students. Further, the number one cause of suicide among college students (and of all suicides) is untreated depression. Untreated mental illness doesn t disappear, though, after the student graduates and becomes a licensed professional; it can continue well into one s professional veterinary career. Factors that may influence the expression of various mental illnesses (such as depression or obsessive compulsive disorders) and have been linked to suicides among veterinarians are: Stress Family history of addiction and/or mental illness Failure to diagnose or seek treatment of mental illness Lack of knowledge related to stressors Relationship and sexuality issues Lack of willingness to get help based upon the fear of career-related damage Where should education begin for members of our profession? Should it begin before one enters veterinary school? Should it be part of the evaluation process? How could this be implemented? According to our survey circulated among institutions training veterinary students, the need for wellness programs has never been more urgent. continued on next page June CVO Update

13 Member Wellness Veterinarians and Wellness: Doctor, Heal Thyself! Road to wellness must become a visible, accessible path continued from previous page Ironically, our sampling of students surveyed aligns almost exactly with the findings of ACHA-NCHA II 2012; nearly 19% of the students surveyed either did not know or had been diagnosed with a mental illness. There is, however, a significant gap between the student numbers and those of the licensed veterinarians in the state of Alabama. 66% of the licensed veterinarians surveyed indicated that they had been clinically depressed. Notable age differences compounded with life experiences potentially contributed to these very different numbers. Additionally, there are a couple of factors that should solicit concerns. These factors can and need to be addressed within our veterinary schools, associations, and licensing boards. A survey by the Association of Executive Veterinary Directors illustrated that 54% of the states had a wellness program for veterinary professionals. Within the state of Alabama, however, and in spite of what is considered to be a highly successful veterinary professionals wellness program, 54% of the survey s recipients were unaware of the program s existence. 44% of those surveyed had not heard of the veterinary professionals wellness program and only 2% are now or have previously participated in the program. What is the cause of the significantly higher cases of depression and other mental health issues among graduate veterinarians? In addition to the stressors that are common to both the students and the graduate veterinarians (finance, relationships, rest, depression, anxiety, addictions and other mental health issues) other factors may also play a role. As the use of electronics has incorporated itself within society s infrastructure, it has also created a unique set of issues. Clearly, there is a serious disconnect between conveying information about the program versus those individuals we hope to reach. The direct source of the problem has not been determined; although important questions are now being asked. Matters regarding the investment of adequate capital to aid our most important resources, our students and our veterinary colleagues, are presently being discussed among our professional community. Even though the state of Alabama has a very good veterinary professional wellness program by most standards, the results of our survey clearly indicate we ve only just begun. By recognizing that problems exist and that confidential help is available, we, as medical professionals, can work together towards finding a solution. The road to wellness must become a visible, accessible path, illuminated through the collective guidance and wisdom surrounding our noble profession. POSTSCRIPT: The PHP Program in Ontario is available to all licensed members of the College and to all undergraduate veterinary students at the OVC. For confidential advice about next steps and collegial support for you, a family member, someone you know, or a colleague, please contact the PHP at or online at Confidential Ontario Toll-free Line: Professionals Health Program The Professionals Health Program is a free, confidential service. The PHP provides prompt advice and support to veterinarians and/or their family members. CVO Update 13 June 2013

14 Facility Accreditation A day in the life of a facility inspector Inspectors review up to 300 items during a single inspection Doctor, the Inspector is here! That s how a typical day in the life of a CVO Inspector begins when arriving at your facility to perform an accreditation inspection. But what about before the inspection date? What happens before the Inspector appears? Before the actual inspection a fair amount of planning and preparation is done by the Inspector, and other College staff involved in accreditation. The facility due for inspection is notified of the date through a letter from the College. The inspection date is set well before the expiration of the current accreditation certificate. If the date is suitable and no change is needed, the necessary paperwork is put together. We often do an Internet search to see what information is available to the public about the facility and the staff, because it s always nice when websites show the premises, their location, and the friendly faces of the people that work there. As inspectors, we understand the inspection occurs during your business hours. We try to be prompt, mindful that appointments are scheduled around the inspection. As those of you with mobile facilities will appreciate, traffic and geography can occasionally present challenges. Because Ontario is so vast the Inspector may have been on the road for several hours, or even several days, traveling to meet the appointed time. Be that as it may, every effort is made to arrive on time. Dealing with staff is usually the highlight of the day for the Inspectors. We realize the accreditation inspection is a major event for the practice owner(s), and in most cases they, and their staff, have spent some time in preparation, and may be a bit anxious, as a positive outcome is crucial. At initial contact, and throughout the inspection process Dick Stewart Accreditation Inspector efforts are made to allay any fears or uncertainty they may have. I may simply ask if there is any area they are unsure off, or whether there is an area they feel needs clarification. Once any concerns are addressed, a heightened comfort level is usually the result. If and when a deficiency is noted, efforts are made to ensure staff understand what is noted and what is needed to correct it. Similarly when items are found that indicate best practices, this too is pointed out, so they become aware their efforts have been seen, and afforded the credit deserved. Inspectors, depending upon the type of facility being inspected will review up to 300 items on a single inspection. If the facility is comprised of more than one class the number increases. Many of the items reviewed are in plain view, but as many are not we must ask to see them. Although the practice of veterinary medicine is performed in each facility, each facility is different from the next. So, whether dealing with an initial inspection, to allow a new facility to open, to re-inspecting an established practice that may be undergoing its umpteenth inspection, we try very hard, to leave the impression, that the inspection was the best one they have ever had. To say what a typical day in the life of a CVO Inspector might be would be like what Forrest Gump said about a box of chocolates, You never know what you re going to get. Dick Stewart joined the College of Veterinarians of Ontario as an accreditation inspector in Dick is a former Chief of Police in Guelph and also worked for the Canadian Security Intelligence Service. At the College, Dick is a member of the inspection team which includes Brian Redpath and Don Huston. June CVO Update

15 Complaints Case Study Poor communication, lack of informed consent lead to complaint COMPLAINT SUMMARY A member examined a six-monthold dog during his vaccinations. The client inquired about having the dog s cherry eye surgically repaired, possibly with his neuter procedure. The member provided an estimate with a price breakdown for doing both surgeries at the same time, totalling close to $800. Due to financial concerns, the client decided to have only the gland repair eye surgery completed. The surgery was performed that day. The final bill was almost as much as the initial quote for both surgeries. ALLEGATIONS The client indicated s/he would have had both surgeries performed at the same time had s/he known the cost of one surgery was almost as much as what s/he was quoted for both. When the client asked the member about the difference in the initial quote, the member indicated s/he was in too much of a hurry. DECISION The Complaints Committee panel decided the nature of the allegations made against the member did not warrant a discipline hearing and therefore directed this matter not be referred to the Discipline Committee. However, the Complaints Committee panel decided to take the following action under paragraph (c) of subsection 24(2). The member is advised by the Committee of the Committee s concerns regarding the member s conduct in relation to the lack of effective communication and failure to obtain the owner s informed consent. The member is advised to consider this carefully and take any necessary action to ensure the situation does not recur. REASONS FOR DECISION The client was concerned with the final invoice being more than expected. In considering the issue, the Committee was of the opinion there was lack of informed consent by the client in his/her decision to have the dog s eye repaired. The initial estimate was the total cost to perform the neuter and eye repair surgeries at the same time. However, the estimate did not clearly state the bulk of the anaesthetic cost is buried in the neuter fee, and not listed separately. From the estimate provided, it appeared to the client the anaesthetic fee was $61. However, this fee related to extra anaesthetic time, and did not include the anaesthetic fees that were included in the neuter fee. While this may have been obvious to anyone working at the clinic, or in the veterinary profession, it is not obvious to the public, or the client. Given the member had clear indications of the client s financial concerns, the Committee had concerns with the member s failure to obtain informed consent from the owner prior to undertaking the surgical repair of the eye. Given that the owner was making his/her decision solely on the original estimate for the combined procedures, the Committee was of the opinion it was unfair of the member not to provide a new or revised estimate, which would detail the exact charges incurred with eye repair surgery. When the client received the final invoice for the gland repair, s/he confronted the member about the discrepancies, and inquired why s/he had not been informed. The member responded by saying s/he did not have time to listen to the client. This complaint resulted from the lack of informed consent and miscommunication with the client. In the member s submission to the College, s/he acknowledged that s/he probably fell short in this area and the Committee hopes that s/he will be cautious to ensure better understanding from clients in the future. In Case Studies, Update presents a summary of the outcomes of complaints, Mutual Acknowledgement and Undertakings, and reported matters investigated by the College that are considered to be public knowledge. Case Studies are intended to be informative and educational, giving members the opportunity to review situations that highlight their responsibility to uphold professional standards and the College s responsibility to respond to issues that come to its attention. The Complaints Committee considers and investigates complaints made by the public or members of the College regarding the conduct of a member or former member of the College (Veterinarians Act R.S.O. 1990, Chapter V.3). The Complaints Committee is composed of up to nine members of the College (all of whom are practising veterinarians) and one non-veterinarian appointed to the Council of the College by the provincial government. CVO Update 15 June 2013

16 CVO ~ Register Updates The following veterinarians became licensed to practice veterinary medicine in Ontario between February 2, 2013 and May 3, Licence types are: G=General GNR=General Non Resident E=Educational R=Restricted A=Academic PGR=Postgraduate and Resident PS=Public Service Dr. Miranda Abrahams G Dr. Jessica Ibey G Dr. Marie-Andree Poulin Dr. Lowia Al-Hussinee R Dr. Inayatullah G Dr. Gopal Raval Dr. Hugues Beaufrere A Dr. Kevin Iran-Manesh R Dr. Debbie Reynolds Dr. Martin Bonneau G Dr. Adrian Jones G Dr. Leah Seabrook Dr. Hilary Butler G Dr. Jessica Lam G Dr. Veronica Sues Dr. Alyssa Calder G Dr. Katie Lee G Dr. Lizete Valdmanis Dr. Joyce Chiu G Dr. Ellen Melvin-Walsh G Dr. Sartaj Wazir Dr. Chris Grossenbacher G Dr. Dalini Oumade Singh R Dr. Trisha Westers Dr. Shahbaz Ul Haq R Dr. Kishor Patel G Dr. Shael Zelunka Dr. Sean Herzog G Dr. Melanie Petersen G The following veterinarians have had their licences expire: Dr. Nani Munoz Dr. Daniel Rodiguez-Arroyo G R R PS G G R E G Public Register Search the Public Register with Find a Veterinarian at You will find complete information on veterinarians licensed in Ontario including education, professional activities, licence history, discipline proceedings and practice location. New and closed corporations: New Corporations Afzal Veterinary Professional Corporation Blackburn Animal Hospital Professional Corporation Bourdeau Veterinary Professional Corporation Branton Animal Hospital Professional Corporation Brealey Drive Animal Clinic Professional Corporation Calli Laine Thompson Professional Corporation Dewitt Park Animal Hospital Professional Corporation Dr. Anneli Purje Professional Corporation Dr. Jeffrey Kaufmann Veterinary Professional Corporation Dr. Morris Samson Professional Corporation Dr. Raza Professional Corporation Farooq Veterinary Professional Corporation Fruitland Veterinary Professional Corporation Hamilton Road Animal Hospital Professional Corporation Harrison Veterinary Professional Corporation Lane Veterinary Services Professional Corporation Lindsay R. Forsyth Veterinary Professional Corporation Mitelman Veterinary Professional Corporation Renfrew Animal Hospital Professional Corporation Saini-Khakh Veterinary Professional Corporation Sasha Kotzeff Veterinary Professional Corporation Whitehills Animal Hospital Professional Corporation Closed Corporations Dr. Jessica Sherwin Veterinary Professional Corporation Gateway Pet Hospital Professional Corporation Linwood Bovine Veterinary Professional Corporation The following is a list of new, relocated and closed veterinary facilities: New Facilities Barton Grays Animal Hospital, Stoney Creek Dewitt Park Animal Hospital, Stoney Creek Dixie Road Pet Clinic, Brampton Hickman Mobile Veterinary Services, Toronto Hillsview Mobile Veterinary Services, Richmond Hill New Street Animal Hospital, Burlington Rosswell Animal Hospital, Courtice Sherbourne Animal Hospital, Toronto South Whitby Veterinary Services, Whitby Unionville South Pet Hospital, Markham Vellore Woods Veterinary Hospital, Vaughan West Valley Veterinary Services - Western University, London Relocated Facilities Chartwell Veterinary Clinic, Agincourt Cranberry Hill Animal Clinic, Kemptville Dale Veterinary Clinic, Port Hope Renforth Veterinary Clinic, Etobicoke Closed Facilities Baywell Veterinary Services Chris & Colangelo Equine Services Khahra Veterinary Housecall Services Matheson Blvd. Veterinary Services Mountsberg Equine Services Sime Housecall Veterinary Services In Memoriam The Council and staff of the CVO were saddened to learn of the following deaths and extends sincere sympathy to families and friends. In memory of deceased members, the CVO contributes an annual grant to the Ontario Veterinary College Alumni Trust. Dr. Gregory de Gannes, OVC 1988 Dr. Karl Euler, OVC 1961 Dr. Laurie Ann Nicholls, OVC 1977 Dr. Norman Schmidt, OVC 1939 Dr. Melanie Williams, OVC 1974